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Medicaid work requirements

Medicaid and the Road Ahead: Spending Cuts, Work Requirements and What’s Next for States, Providers and Families

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Passed last year, President Trump’s One Big Beautiful Bill Act made significant changes to Medicaid—the primary insurance provider for health and long-term care for people with low incomes. These changes are expected to lead to coverage loss for many current enrollees and will reduce funding for Medicaid, placing new financial pressures on states and health care providers. On July 23, KFF and States Newsroom hosted an event focused on the impacts of work requirements and other federal policy changes on states, health care systems, and people.

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understanding medicaid

Medicaid Financing

Medicaid represents $1 out of every $5 spent on health care in the U.S. and is the major source of financing for states to provide health coverage and long-term care. This brief examines key questions about Medicaid financing and how it works.

Medicaid Program Integrity

This brief explains what is known about improper payments and fraud and abuse in Medicaid and describes ongoing state and federal actions to address program integrity.

Medicaid and Provider Taxes

All states except Alaska cover some state Medicaid costs with taxes on health care providers. This brief uses data from KFF’s 2024-2025 survey of Medicaid directors to describe current practices and the federal rules governing them.

Medicaid and Hospitals

Absorbing reductions in Medicaid spending could be challenging for hospitals, particularly for those that are financially vulnerable. This brief provides data on the reach of Medicaid across hospitals, patients, and charity care.

Medicaid Home Care

This issue brief provides an overview of what Medicaid home care (also known as “home- and community-based services”) is, who is covered, and what services were available in 2025.

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  • Quick Take: An Update on the ACA & HIV: Medicaid Health Homes

    Fact Sheet

    We recently wrote about the different ways in which the Affordable Care Act (ACA) changes pathways to health insurance coverage for people with HIV, and chronicled these specifics, as well as several outstanding questions, in a policy brief.  As we noted, among the many provisions of the ACA designed to improve care is a new option available to state Medicaid programs to provide “health homes” for Medicaid enrollees with chronic conditions, with a temporary enhanced…

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    Report

    This issue paper explores the potential for increasing enrollment in children's health insurance programs through "Express Lane Eligibility." Express Lane Eligibility is the accelerated enrollment of low-income uninsured children already participating in other income-comparable publicly funded programs, such as WIC or school lunch, into Medicaid or CHIP. The paper reviews Express Lane Eligibility's potential impact on Medicaid and CHIP enrollment, analyzes different models, discusses key challenges with implementation, and suggests steps states and localities can…

  • Medicaid’s Role for the Disabled Population Under Age 65

    Fact Sheet

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    Report

    The fourth in a series of reports on implementation issues and challenges in the first year of S-CHIP finds that states have been able to enter arrangements with plans for their S-CHIP population fairly easily. REPORT Download

  • Women and Medicare

    Fact Sheet

    Medicare is a critical source of health insurance coverage for virtually all older women in the U.S. and for many younger women who have permanent disabilities. Because women have longer life expectancies than men, more than half (57%) of the people covered by the program are women. In 1999, there were 21 million women on Medicare 19 million ages 65 and over and another 2 million women under age 65 with disabilities who received Social…

  • Medicaid: Purchasing Prescription Drugs

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  • Low-Income Parents’ Access to Medicaid Five Years After Welfare Reform

    Issue Brief

    This policy brief examines health coverage for low-income parents after the 1996 welfare law broke the historical connection between Medicaid coverage and welfare. Many states have altered their rules and some have expanded coverage for low-income working parents. Policy Brief

  • Medicare+Choice in California: Lessons and Insights

    Report

    Thirty-five percent of all California Medicare beneficiaries are enrolled in a M+C plan, far in excess of the 14 percent rate nationwide. This report seeks to identify what lessons for the nation can be drawn from the California M+C experience, as Congress debates the implications of major withdrawals from the M+C program and potential policy changes aimed at reversing this trend. The report is based largely on analysis of M+C data on plan participation, withdrawals,…